Developmental optometrists in Vancouver treat adults with convergence insufficiency

Some people are are wondering about whether vision therapy is as effective for adults with convergence insufficiency, as it is for children.  

The developmental optometrists at our Vancouver eye clinic have successfully treated many adults with convergence insufficiency using vision therapy.

And, if that clinical experience were not enough, the scientific research backs it up.

In 2005 Scheiman et al. published a clinical trial in Optometry and Vision Science on the vision therapy treatment of convergence insufficiency in young adults ages 19-30.
  
Basically, the results were that vision therapy was an effective treatment for convergence insufficiency in this age group and that pencil push-ups were not effective.  Here is a quote from the study where the authors state their conclusions:

"This first multicenter, randomized clinical trial of the treatment of symptomatic CI in young adults demonstrated that of the three treatment modalities, only vision therapy/orthoptics was effective in achieving normal clinical values for both the near point of convergence and positive fusional vergence. Patients in the pencil pushups group achieved normal values only for positive fusional vergence at near and patients in the placebo vision therapy/orthoptics group did not achieve normal findings for either the near point of convergence or positive fusional vergence at near.Therefore, the effectiveness of vision therapy/orthoptics in improving the near point of convergence and positive fusional convergence values at near in adults cannot be explained on the basis of a placebo effect. Based on the results of this preliminary study, it would appear that pencil pushups, the most popular treatment for CI, is not effective for achieving clinically significant improvements in symptoms or signs associated with CI in young adults." [emphasis added]

You can learn more here: http://www.visiontherapy.ca/binocularvision.html
and here: http://www.visiontherapy.ca/convergence.html

More evidence that patching alone is not enough for amblyopia treatment in adults

There was an excellent post on adult amblyopia at mainosmemos.com about this study: Dichoptic training enables the adult amblyopic brain to learn

The summary of the study is as follows:

....Adults with amblyopia, a common visual cortex disorder caused primarily by binocular disruption during an early critical period, do not respond to conventional therapy involving occlusion of one eye. But it is now clear that the adult human visual cortex has a significant degree of plasticity, .... One possibility is an inhibitory signal from the contralateral eye that suppresses cortical inputs from the amblyopic eye. .... Here we provide direct evidence that alleviating suppression of the amblyopic eye through dichoptic stimulus presentation induces greater levels of plasticity than forced use of the amblyopic eye alone. This indicates that suppression is a key gating mechanism that prevents the amblyopic brain from learning to see.....

The way we have been treating amblyopia at our Vancouver clinic has always been a two-eyed or binocular vision centric approach.  We have seen first hand that this approach is far better than patching alone - it results in better, faster and more permanent results with better depth perception and all the other benefits that come with developing good functioning binocular vision.

Dr. Maino's comments on the study are spot on:

The research continues to show that adults with amblyopia have a treatable condition AND that amblyopia is not just related to decreased visual acuity in one eye. Amblyopia is a two-eyed-brain problem! When are my colleagues going to realize that you should not treat amblyopia by patching alone?

We wrote a similar post recently, see "Patching alone is not enough for amblyopia treatment".